University of Edinburgh

Visual Impairment Scotland Research

Description of the Characteristics of Children with Dual Sensory Impairment

Blaikie AJ, Ravenscroft J, Buultjens M, Dutton GN, Visual Impairment Scotland Research Group

Royal College of Ophthalmologists Congress
Birmingham, May 2003


To the authors knowledge there are no specific descriptive studies on dual sensory impairment in childhood. Where studies have recorded hearing impairment in populations of children with visual impairment wide variations (6.2% to 12%) in prevalence have been described (1,2). The purpose of this study was to describe the frequency and characteristics of children with dual sensory impairment on a Scotland-wide childhood visual impairment notification system.


The electronic database of Visual Impairment Scotland's (VIS) childhood notification system was analysed. Information on the education and health of children was acquired from parents, educational institutions and health professionals.


Frequency of Dual Sensory Impairment

13.8% (46/333) of under 16 year olds with 'significant visual impairment' (visual acuity worse than 6/18 and/or any visual field loss and/or cognitive visual dysfunction) were also reported to have additional hearing impairment.

Visual Function

Nearly one third (30%) of children were found in NORDSYN(3) visual function groups C ('near total blindness') and Group D ('total blindness').


Additional Disabilities

Nearly all children (93.5%) had further additional disabilities. The most common combination of disabilities (63%) was learning and physical impairment in addition to dual sensory impairment.


Anatomical Site of Visual Impairment

The most common anatomical site of visual impairment was the brain (59% of cases).

Conditions Leading to Visual Impairment

A wide range of visually impairing conditions (20) were described in the 46 children. The two most common causes of visual impairment described by health professionals were cerebral palsy (9 cases) and cerebral visual impairment (5 cases).



The majority (59%) of children acquired the impairing condition prenatally. One third (33%) acquired the condition that lead to impairment in and around the time of birth. Prematurity and oxygen deprivation are the two main causes of impairment at this time.

No children in this study acquired dual sensory impairment after the first 28 days of life (postnatally).

Educational Placement, Record of Needs Status and Blind/Partial Sight Registration

Complete educational information was available on 32 of the 46 children with dual sensory impairment. Of the children of school age most (16/23) were in mainstream education. Only a minority were placed in Special Schools (7/23).


Overall just over half (18/32) had a Record of Needs in place. Exactly half(16/32) were registered blind or partially sighted. Over one third (11/32) of children with dual sensory impairment were neither registered blind or partially sighted or subject to a Record of Needs.


Children with dual sensory impairment present a greater challenge to health, education and social services than children with isolated visual impairment. The percentage of children in this study with dual sensory impairment (13.8%) was higher than in previous studies and very much higher than the official blind and partial sight register (1.5%) in Scotland 4. The challenge of providing services to this group of children is further complicated by the wide variety of impairing conditions, the presence of further additional disabilities and many children having especially poor visual function.

It is hoped that this study can help to inform the future development of appropriate integrated service provision involving education, social services, health and voluntary organisations for children with visual impairment and in particular those with additional hearing impairment.


1. Blohme J, Tornqvist K, Visual impairment in Swedish children. II. Etiological factors. Acta Ophthalmol Scand. Apr 1997, 75(2):199-205.
2. Riise R, Flage T, Hansen E, Rosenberg T, Rudanko S-L, Viggosson G, Warburg M. Visual impairment in Nordic children. I. Nordic registers and prevalence data. Acta Ophthalmol 1992 70 145-154.
3. (website defunct see 1)
4. Social Work Statistics Release, Registered Blind and Partially Sighted Persons, Scotland November 2002

John Ravenscroft
VI Scotland, SSC